| NPI | 1881721553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001323) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 000571) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2021-01-27 |