| NPI | 1518397074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60830326) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 15656) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2022-01-26 |