| NPI | 1043864481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP4264) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 18636) |
| 171100000X Acupuncturist (Licence: NJ 25MZ00142900) | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2023-02-16 |