| NPI | 1396305504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ID ACU-361) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 006550) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2023-11-30 |