| NPI | 1619384575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198.000782) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WI 578-055) |
| 171100000X Acupuncturist (Licence: CO 578) | |
| 171100000X Acupuncturist (Licence: IN 84000096A) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |