| NPI | 1760089007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CT 774) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 6822) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |