| NPI | 1689735599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 041414) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: GA 041414) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-08-13 |