| NPI | 1225724370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC00019702) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA AC00019702) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |