| NPI | 1801870688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VT 091.0059682) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC8977) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2020-07-22 |