| NPI | 1528178522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD417766) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA PAK000208) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-12-12 |