| NPI | 1649457995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TN ACU0000000054) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP191) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2009-07-27 |