| NPI | 1861666158 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 491) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 3749) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2021-12-27 |