| NPI | 1003384926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001281) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: VT 099.0134073) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |