| NPI | 1528233699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WI 266055) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 2966012) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |