| NPI | 1548499262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 238415) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: MA MT00132) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2016-03-22 |