| NPI | 1649453648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WV 96211) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000482) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2018-06-20 |