| NPI | 1407173024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC01114) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC3139) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2010-04-21 |