| NPI | 1265646244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00000138) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MA 60026945) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2013-01-27 |