| 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 |