| NPI | 1790734929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC00002516) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AR DOM 0046) |
| 171100000X Acupuncturist (Licence: NY 001734) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2007-07-08 |