| NPI | 1164578571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC458) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA8686) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |