| NPI | 1235485814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC 60343617) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VT 0910077315) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2013-07-17 |