| NPI | 1730696246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA OM000234) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN147147) |
| 163W00000X Registered Nurse (Licence: PA RN703740) | |
| 171100000X Acupuncturist (Licence: AZ 1081) | |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-06-21 |