| NPI | 1073867123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 738384) |
| Enumeration Date | 2012-10-27 |
| Last Update Date | 2024-06-28 |