| NPI | 1932392297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 11235) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 674) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2009-04-14 |