| NPI | 1053559260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC01211) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC11513) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2015-12-07 |