| NPI | 1679537872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC 60619873) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC00901) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2016-01-19 |