| NPI | 1588220834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006525) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO ACU.0002746) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-05-06 |