| NPI | 1205066370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC12897) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 12897) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2013-02-26 |