| NPI | 1710413117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: SC TL280) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL FL3777) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2017-05-04 |