| NPI | 1801697552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001418) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NC LAC-1095) |
| Enumeration Date | 2025-03-20 |
| Last Update Date | 2025-03-20 |