| NPI | 1407040561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 182) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 012100457) |
| 171100000X Acupuncturist (Licence: MD V01584) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2010-08-23 |