| NPI | 1225171028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC152667) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC11300) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2014-01-17 |