| NPI | 1821432659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC168258) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 15357) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2014-09-30 |