| NPI | 1376105825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006683) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000929) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2021-07-19 |