| NPI | 1427058171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H4714) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX h4714) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2010-12-17 |