| NPI | 1386835015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK000787) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198.000572) |
| 171100000X Acupuncturist (Licence: OH 65.000089) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |