| NPI | 1760836308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002187) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WI 867-55) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |