| NPI | 1225371800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 15164) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: 154560) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-07-27 |