| NPI | 1083176606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KS 23-00003) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MO 2014029641) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |