| NPI | 1619625878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA OM000309) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL 4235) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2022-03-16 |