| NPI | 1043450984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 003870) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MA 237861) |
| 171100000X Acupuncturist (Licence: CT 000456) | |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2009-03-05 |