| NPI | 1679925473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 1068) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC01653) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |