| NPI | 1003584863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ME AC693) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC02076) |
| Enumeration Date | 2021-09-05 |
| Last Update Date | 2024-02-19 |