| NPI | 1801619564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 0002) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 433) |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-01 |