| NPI | 1700051992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MN 1281) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 10303) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2022-07-21 |