| NPI | 1285177436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC01657) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO ACU.0002150) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2022-03-31 |