| NPI | 1386075851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000841) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA ac15349) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2020-01-09 |