| NPI | 1740602929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60392092) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA OM000165) |
| 171100000X Acupuncturist (Licence: MT MED-ACU-LIC-26569) | |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |