| NPI | 1528188943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0001915) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000772) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2015-01-19 |