| NPI | 1629149729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U00524) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: DC AC73) |
| 171100000X Acupuncturist (Licence: VA 0121000160) | |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2007-07-08 |