| NPI | 1053777276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC61405297) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA ac 15765) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2023-05-01 |