| NPI | 1619198637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 2499) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MA 220208) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2008-01-07 |