| NPI | 1861950446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000941) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019006078) |
| 171100000X Acupuncturist (Licence: DC AC500315) | |
| 171100000X Acupuncturist (Licence: MD U02615) | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2020-10-20 |