| NPI | 1326247016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U01592) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 11889) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2012-10-12 |