| NPI | 1679842579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD 808371) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: DC AC500148) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2015-03-01 |