| NPI | 1295060093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA OM000261) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 981) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2020-02-17 |