| NPI | 1780157040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MT med-acu-lic-70143) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AK 138929) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |