| NPI | 1164630398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK000484L) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001004-1) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2007-07-08 |