| NPI | 1427391150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 255748) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MA 868337) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2018-12-02 |