| NPI | 1376797753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC01318) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC12589) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2012-03-10 |