| NPI | 1649341843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 163531) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 163531) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2014-04-30 |