| NPI | 1366531758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00001891) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00014480) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-01-19 |