| NPI | 1336498088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 0002108) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO MT13033) |
| Enumeration Date | 2012-09-09 |
| Last Update Date | 2015-06-05 |