| NPI | 1124303870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MT MED-ACU-LIC-104849) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC61123606) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2022-06-24 |