| NPI | 1912467796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC225946) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC70005542) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-08-10 |