| NPI | 1609153782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA om000089) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 1485) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2012-12-19 |