| NPI | 1700135480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U01518) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000521) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2020-04-22 |