| NPI | 1720463094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005611) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA OM000168) |
| 171100000X Acupuncturist (Licence: CA AC 15770) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |