| NPI | 1639310121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 2260) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 19750) |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2025-02-26 |