| NPI | 1851717227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 338) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC16464) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2020-06-29 |