| NPI | 1982429445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC LAC-2280) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 007622) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2025-01-30 |