| NPI | 1295956431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 6589) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 254) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PR 6589) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-09-21 |