| NPI | 1376642819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00000252) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT00000555) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-12-18 |