| NPI | 1932300902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC01609) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 11621) |
| 171100000X Acupuncturist (Licence: VA 0121000589) | |
| 171100000X Acupuncturist (Licence: IL 198.000977) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2025-07-10 |