| NPI | 1114226875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 14101) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK001287) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2019-02-28 |