| NPI | 1861957789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ID ACU-436) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC61172209) |
| 171100000X Acupuncturist (Licence: OR AC190542) | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2022-04-06 |