| NPI | 1699040840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 251248) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC00828) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2022-07-21 |