| NPI | 1932261732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MA00007482) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00001965) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2025-09-11 |