| NPI | 1508206731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 2138) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 15456) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2019-08-28 |