| NPI | 1689318735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000979) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2024-05-20 |