| NPI | 1487805974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 12535) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI 862) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2015-07-09 |