| NPI | 1629240320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CT 0393) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 003404) |
| 171100000X Acupuncturist (Licence: CT 393) | |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2020-10-22 |