| NPI | 1306154935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 386) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC13626) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2020-01-22 |