| NPI | 1902172844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WV WV-96161) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: TX L6560998) |
| 171100000X Acupuncturist (Licence: DC AC500027) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2018-09-26 |