| NPI | 1033261698 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC 10932) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198.001687) | 
| Enumeration Date | 2007-01-16 | 
| Last Update Date | 2025-03-24 |