| NPI | 1043725807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 1055) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 006131-1) |
| Enumeration Date | 2017-12-02 |
| Last Update Date | 2020-02-25 |