| NPI | 1407020530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR 119) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA CF 2810) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |