| NPI | 1811391485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000741) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02358) |
| 171100000X Acupuncturist (Licence: DC AC500235) | |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2019-09-16 |