| NPI | 1912077272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ME AC753) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001776) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2023-11-01 |