| NPI | 1295729671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 693) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC00484) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2013-01-04 |