| NPI | 1962662494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 515) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000788) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2022-06-27 |