| NPI | 1578894804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA OM000063) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA #0121000545) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2012-06-20 |