| NPI | 1245454453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00000557) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00002016) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |