| NPI | 1720228133 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC 822) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 8372) | 
| Enumeration Date | 2009-02-25 | 
| Last Update Date | 2009-02-25 |