| NPI | 1386350668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 4422) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL 4422) |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-01-30 |