| NPI | 1265115661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121001125) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL 4158) |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2024-01-10 |