NPI | 1659660090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0320133990) |
Additional Taxonomies | 202D00000X Integrative Medicine (Licence: VT 032.0133990) |
204D00000X Neuromusculoskeletal Medicine & OMM (Licence: VT 032.0133990) | |
207Q00000X Family Medicine (Licence: OH 34.012111) | |
171100000X Acupuncturist (Licence: VT 032.0133990) | |
Enumeration Date | 2011-04-06 |
Last Update Date | 2023-12-21 |