| NPI | 1518029867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC LAC-2208) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C005637) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2023-11-27 |