| NPI | 1558541151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000637) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 333) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2013-05-09 |