| NPI | 1144653064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001084) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005122) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2013-08-14 |