| NPI | 1972960391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121001034) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 18201) |
| Enumeration Date | 2016-01-16 |
| Last Update Date | 2023-06-21 |