| NPI | 1528441896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KY AC058) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000576) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-06 |