| NPI | 1619964558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 031RX1) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 031) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2008-09-03 |