| NPI | 1073800306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 254238) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004510) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2015-02-24 |