| NPI | 1073723706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: SC 165) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NH 078) |
| 171100000X Acupuncturist (Licence: ME 247) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2014-03-10 |