| NPI | 1144608290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NV 2014) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 16544) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2018-07-16 |