| NPI | 1891874996 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NV 1031) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 10063) | 
| Enumeration Date | 2006-11-02 | 
| Last Update Date | 2017-02-09 |