| NPI | 1023186863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 13577) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 002949) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2010-12-09 |