| NPI | 1790841021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U01495) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001766) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-10-11 |