| NPI | 1659434496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002218) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC01033) |
| 171100000X Acupuncturist (Licence: WA 60003843) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2019-01-23 |