| NPI | 1831237452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60239555) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA 2717) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2012-11-15 |