| NPI | 1689790131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 206116) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC00403) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-03-06 |