| NPI | 1174862841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00002184) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00014541) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-01-31 |