| NPI | 1912237553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004644) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 13138) |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2014-06-16 |