| NPI | 1639782253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ LAC-012235) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 18825) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2025-05-06 |