| NPI | 1093469561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MI 5402000295) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC208298) |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2025-09-12 |