| NPI | 1013067131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 236) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC7613) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2012-05-17 |