| NPI | 1902491541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ID ACU-441) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC61091662) |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2023-12-16 |