| NPI | 1508113796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 269376) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: RI daom0056) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2018-03-17 |