| NPI | 1174991079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198.000069) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WI 405-55) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |