| NPI | 1902227648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 363) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL 3382) |
| Enumeration Date | 2013-12-24 |
| Last Update Date | 2016-06-24 |