| NPI | 1255997417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: RI DA00486) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MA 281885) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2026-02-12 |