| NPI | 1356886501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001185) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005730) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-27 |