| NPI | 1205155785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60493370) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198000925) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2019-06-11 |