| NPI | 1114053675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC00497) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX 00497) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2024-07-07 |