| NPI | 1437202256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP2746) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA 2852) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2010-01-07 |