| NPI | 1639481567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA 000330) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC01182) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2023-09-20 |