| NPI | 1982602942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY A1711711) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 000427) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2022-08-16 |