| NPI | 1053568782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AK 117) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00003084) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-09-10 |