| NPI | 1235743360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MN 1892) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IA A-111) |
| Enumeration Date | 2020-09-05 |
| Last Update Date | 2020-09-05 |