| NPI | 1285883678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 303) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001424) |
| 171100000X Acupuncturist (Licence: NC 466) | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2013-06-05 |