| NPI | 1750549762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP3103) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MN 1322) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2013-03-06 |