| NPI | 1023162633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001027) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP1018) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2018-08-08 |