| NPI | 1104363175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005918) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005918-1) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-10-19 |