| NPI | 1558492116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00000317) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 814) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |