| NPI | 1386788859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00589) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 636 407) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2012-02-16 |