| NPI | 1265653208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TN ACU 8) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: KY AC 7) |
| 171100000X Acupuncturist (Licence: RI DA 107) | |
| 171100000X Acupuncturist (Licence: CA AC 4290) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2009-03-02 |