| NPI | 1730334079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD052287L) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000401L) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |