| NPI | 1427300441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CT 000532) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 4600) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |