| NPI | 1831545862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002505) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 17106) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2024-10-14 |