| NPI | 1306818398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 061) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NM 1039) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2011-05-02 |