| NPI | 1528381167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 002897) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000408) |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2011-07-14 |