| NPI | 1891084331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004407) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VT 091.0067258) |
| 171100000X Acupuncturist (Licence: CT 518) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2012-04-09 |