| NPI | 1497245724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000412) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U01107) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |