| NPI | 1366562324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA OM000003) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000496L) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2013-11-13 |