| NPI | 1629197934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00498) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00002588) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2014-10-06 |