| NPI | 1336902931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC LAC-2252) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121001124) |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-08-01 |