| NPI | 1275766735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC 60172364) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 14600) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2012-12-31 |