| NPI | 1457886939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC01918) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005892-1) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2020-06-30 |