| NPI | 1306663349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121001177) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U03052) |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-12-15 |