| NPI | 1366784399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60284043) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 14626) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2016-02-22 |