| NPI | 1275774622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 12165) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00074800) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2010-05-25 |