| NPI | 1528309192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004744) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 025112) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2015-01-26 |