| NPI | 1285039941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK00150) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00108400) |
| 171100000X Acupuncturist (Licence: NY 005364-1) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2015-10-06 |