| NPI | 1265791131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121-000669) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U01956) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-26 |