| NPI | 1215157920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 508) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP69) |
| 171100000X Acupuncturist (Licence: RI DA00015) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2018-07-02 |