| NPI | 1356566533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 002740) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP2776) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2014-07-18 |