| NPI | 1801246376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002414) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198001322) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2019-03-06 |