| NPI | 1851363493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 6328) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 485) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-07-08 |