| NPI | 1023567955 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KY AC115) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WI 905-55) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2019-02-19 |