| NPI | 1669721882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005694)  | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 14736)  | 
| Enumeration Date | 2012-09-04 | 
| Last Update Date | 2016-02-23 |