| NPI | 1831570084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 4148) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 16634) |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2022-04-19 |