| NPI | 1730502501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60437922) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA HP60239225) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2020-04-29 |