| NPI | 1821357468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO DORA # 1749) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO NCCAOM # 150098) |
| 171100000X Acupuncturist (Licence: CO DORA # 5298) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |