| NPI | 1053508119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60015192) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC11671) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2019-11-06 |