| NPI | 1841697315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OH 66.000081) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 6107) |
| 171100000X Acupuncturist (Licence: CA 16247) | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2022-03-01 |