| NPI | 1801116868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WV 96203) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP1513) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2010-06-01 |