| NPI | 1588850341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U02470) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 19332) |
| 183500000X Pharmacist (Licence: VA 0202210523) | |
| 183500000X Pharmacist (Licence: TN 40044) | |
| 183500000X Pharmacist (Licence: NY 040538) | |
| 183500000X Pharmacist (Licence: TX 58095) | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2018-01-17 |