| NPI | 1760509871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC01759) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: RI DA00217) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2023-03-27 |