| NPI | 1184161036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI 1292) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC179867) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2020-02-06 |