| NPI | 1023316650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 247302) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NH 186) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2012-01-23 |