| NPI | 1821133984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IA 41) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 11851) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2018-03-17 |