| NPI | 1255720231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006019) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000988) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2023-10-31 |