| NPI | 1023433398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 383) |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: NC 6167) |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2019-02-12 |