| NPI | 1396942058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 377) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 11172) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2010-01-22 |