| NPI | 1659586139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 024) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: SC 264) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-02-19 |