| NPI | 1154763621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60393129) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR 163255) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-11-06 |