| NPI | 1144565417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KY TAC93) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC15067) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2015-06-11 |