| NPI | 1699952051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198.000803) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 11999) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2023-10-10 |