| NPI | 1447801626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 12935) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC36749) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2024-04-11 |