| NPI | 1265561690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121 000105) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U00478) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |