| NPI | 1073715850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00002972) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00020535) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2008-11-02 |