| NPI | 1053617480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 314) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 13434) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2021-10-07 |