| NPI | 1508924648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK000697) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN659121) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-11-21 |