| NPI | 1669489183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 11223) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 329) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-03-07 |