| NPI | 1073824371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WI 673-055) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP2809) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2011-04-15 |