| NPI | 1316453087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00902) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR 1395) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |