| NPI | 1497009054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60306480) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198.001022) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |