| NPI | 1831601004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: RI DAOM00072) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: RI DA00473) |
| Enumeration Date | 2017-10-28 |
| Last Update Date | 2021-07-15 |