| NPI | 1669508909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60201771) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC6556) |
| 171100000X Acupuncturist (Licence: WA TP60201771) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2026-03-26 |