| NPI | 1518096338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00002775) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC00954) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2019-12-03 |