| NPI | 1710388780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121-000725) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02064) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2020-12-04 |