| NPI | 1154503290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 3475) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 11909) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2022-07-21 |