| NPI | 1962173237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MI 5402000135) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MI 5401000250) |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2021-10-11 |