| NPI | 1720035892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301059613) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MI 4301059613) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-02-19 |