| NPI | 1619160074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ME AC 192) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 567) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2025-10-23 |