| NPI | 1033570791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: DC AC500245) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02302) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2020-07-21 |