| NPI | 1144570953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VT 091.0107964) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004865) |
| 171100000X Acupuncturist (Licence: NJ 25mz00094000) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2020-07-20 |