| NPI | 1134537012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA LAC14517) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 14517) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2025-04-16 |