| NPI | 1851574933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: RI DAOM00012) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 000084) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2020-01-10 |