| NPI | 1972982395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AR L.AC.067) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AC01372) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |