| NPI | 1689882045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MO 2008025556) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 111) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-07-05 |