| NPI | 1205160546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OH 65.000176) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: KY AC048) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2010-01-07 |