| NPI | 1033645817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC210428) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 17282) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-05-11 |