| NPI | 1831272616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 002434) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: RI DA00200) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2016-03-28 |