Deactivation Date: 3/31/2023
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Art Specialist/Technologist |
246ZA2600X |
| NPI Number | 1801304621 |
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| LBN Legal business name | ID ACUPUNCTURE | ||||
| Authorized official | BYOUNG WOOK MIN - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/15/2018 | ||||
| Last updated | 03/17/2018 - About 8 years ago | ||||
| Identifiers |
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