| NPI | 1811963788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00913) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00002694) |
| 171100000X Acupuncturist (Licence: MA 203046) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |