| NPI | 1649464512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00000694) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC6718) |
| 171100000X Acupuncturist (Licence: VA 0121000183) | |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |