| NPI | 1316185291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60043511) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC01236) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |