| NPI | 1215005590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI AC814) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC410) |
| 171100000X Acupuncturist (Licence: WA AC1865) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2007-07-11 |