| NPI | 1730360454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC00864) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC14411) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2015-12-16 |