| NPI | 1851445654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0001234) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC6485) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-07-14 |