| NPI | 1245405471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CT 000341) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 002943) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |