| NPI | 1306099569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00002826) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00019464) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2011-12-07 |