| NPI | 1548576358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP1711) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004403-1) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2016-09-27 |