| NPI | 1295542421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CT 896) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MA 6014217) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2025-07-31 |