| NPI | 1770648958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC 203) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA CE 2559) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |