| NPI | 1679268551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U00923) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000310) |
| 171100000X Acupuncturist (Licence: DC AC30078) | |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2023-04-07 |