| NPI | 1033530001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC170159) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 10244) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2015-07-16 |