| NPI | 1740530831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004706-1) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 11821) |
| Enumeration Date | 2012-09-15 |
| Last Update Date | 2019-04-12 |