| NPI | 1356349690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC8637) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC24418) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2025-09-11 |