| NPI | 1427039239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD420579) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA PAK000164) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2021-07-20 |