| NPI | 1154483311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 600) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 002950) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2014-10-05 |