| NPI | 1992980072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 000619-01) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 034610) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2022-08-23 |