| NPI | 1417581539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ LAC-010133) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: 5063) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-08-25 |