| NPI | 1942745591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CT 0603) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005893-1) |
| 171100000X Acupuncturist (Licence: NY 05893) | |
| 171100000X Acupuncturist (Licence: CT 0648) | |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-11-01 |