| NPI | 1326010984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IA 17915) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 17915) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2013-11-15 |