| NPI | 1871253195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007069-01) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CT 000691) |
| 175F00000X Naturopath (Licence: VT 099.0134143) | |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2023-08-10 |