| NPI | 1801587522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121001140) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02964) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2025-04-28 |