| NPI | 1205148467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MI 5402000092) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60137788) |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2025-09-08 |