| NPI | 1093246431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VT 091.0134024) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 006024) |
| 174400000X Specialist (Licence: NY 023540) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2019-08-29 |