| NPI | 1417059957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A48504) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 7887) |
| 175L00000X Homeopath (Licence: NV 9007) | |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2023-06-14 |