| NPI | 1750553269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WI 538-055) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO Acu 1322) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2024-06-19 |