| NPI | 1760754022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 402) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000494) |
| 171100000X Acupuncturist (Licence: CO 1640) | |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2019-10-09 |