| NPI | 1568529857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 001840) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 001840-1) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-02-11 |