| NPI | 1659917037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006640) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: 006640) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2021-03-17 |