| NPI | 1477884989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 1595) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VT 091.0000100) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2017-01-27 |