| NPI | 1518312768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U02124) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: MD ATC116) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |