| NPI | 1154086692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KY TAC134) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA OM000301) |
| Enumeration Date | 2021-10-31 |
| Last Update Date | 2023-07-23 |