| NPI | 1326482522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MI L458606) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC 60337888) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2015-01-21 |