| NPI | 1114196276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: DE CQ-0000023) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC9686) |
| 171100000X Acupuncturist (Licence: PA OM000100) | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2018-04-16 |