| NPI | 1659783439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 457) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005289) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2020-12-02 |