| NPI | 1073880217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC157561) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004631) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2013-02-20 |