| NPI | 1306190038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60307412) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U01952) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |