| NPI | 1164692679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: DC AC500098) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U01696) |
| 171100000X Acupuncturist (Licence: VA 0121000548) | |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2011-12-27 |