| NPI | 1306843552 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 5404) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 726996) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2015-02-24 |