| NPI | 1407683691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121001160) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02999) |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2025-01-12 |