| NPI | 1154599090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60199210) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 0489) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2017-04-19 |