| NPI | 1790925162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 001689) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP 1607) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2019-07-19 |