| NPI | 1962757575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: KS 23-00018) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-05645) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2019-08-01 |