| NPI | 1073682837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 5424) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 644) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-03-28 |