| NPI | 1750038162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ LAC-011985) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02842) |
| Enumeration Date | 2022-03-05 |
| Last Update Date | 2023-02-15 |