| NPI | 1730318775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U01980) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000745) |
| 171100000X Acupuncturist (Licence: DC AC500190) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2015-02-09 |