| NPI | 1053898577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC17767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 458679) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |