| NPI | 1679700793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004969) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC12688) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2019-11-27 |