| NPI | 1154799245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198.000439) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR 1121) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |