| NPI | 1477654606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC7399) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MA 209214) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |