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 |