| NPI | 1578606539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00696) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI ACU 936) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2011-05-26 |