| NPI | 1417044306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD UO 1503) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI 1047) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-10-19 |