| NPI | 1225298805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 1604) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 11234) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2015-08-14 |