| NPI | 1881961373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MN 1537) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WI 627-055) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |