| NPI | 1487782165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 1143) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 2722) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2018-10-16 |