| NPI | 1306986856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004643-01) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP1836) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2023-03-17 |