| NPI | 1144372921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC9332) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 9332) |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-07-21 |