| NPI | 1821305764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CT 000488) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 208303176) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2015-11-18 |