| NPI | 1609062421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004549) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: VT 99.0047100) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2020-10-19 |