| NPI | 1972925618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 287173) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 000772) |
| 171100000X Acupuncturist (Licence: IL 198.001061) | |
| 171100000X Acupuncturist (Licence: NY 006198-1) | |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2021-07-10 |