| NPI | 1790026821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC217881) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC01358) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2025-10-27 |