| NPI | 1184176091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OK BAcu03012013-1) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2021-08-19 |