| NPI | 1558374876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01058292A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35059563B) |
| 171100000X Acupuncturist (Licence: IN 01058292B) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-03-10 |