| NPI | 1215359781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR 190492) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 1932) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2025-04-30 |