| NPI | 1114974565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002635) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MT MED-ACU-LIC-41018) |
| 171100000X Acupuncturist (Licence: OR AC00919) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2023-09-27 |