| NPI | 1902344476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX 02056) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 16788) |
| Enumeration Date | 2017-02-05 |
| Last Update Date | 2022-06-29 |