| NPI | 1215957329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OH 65.000049) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 579) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-01-28 |