| NPI | 1164103370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001372) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02853) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |