| NPI | 1225395767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: UT 10339521-1201) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 65.000131) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2025-01-23 |