| NPI | 1164661450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA 60132448) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA 60172725) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2011-07-18 |