| NPI | 1174043541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 427) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC15330) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2020-11-18 |