| NPI | 1568729275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U01977) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC8442) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2014-09-22 |