| NPI | 1780935916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP2653) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WI 661-55) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-09-27 |