| NPI | 1740579119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60209968) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI ACU964) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2011-04-06 |