| NPI | 1922342419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC160475) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC15033) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2014-02-28 |