| NPI | 1154965267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ 010137) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AZ 20-1888) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2021-10-26 |