| NPI | 1174955470 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC164157)  | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR 164157)  | 
| 171100000X Acupuncturist (Licence: CA 21349)  | |
| Enumeration Date | 2013-08-08 | 
| Last Update Date | 2016-11-08 |