| NPI | 1295853513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KY ky13) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 1199) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |