| NPI | 1346590247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC159739) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 1182) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2015-10-19 |