| NPI | 1801462973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: DC AC500205) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02183) |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2024-02-14 |