| NPI | 1982076972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: SC 378) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 000324) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2022-01-11 |