| NPI | 1366595159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX 755) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: TX NA08423785) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-01-05 |