| NPI | 1730709916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000581) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: DC AC500109) |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |