| NPI | 1639494636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U01462) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R113773) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2012-09-26 |