| NPI | 1528120664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP1678) | 
| Additional Taxonomies | 175F00000X Naturopath (Licence: DC NAT1000686) | 
| Enumeration Date | 2006-12-14 | 
| Last Update Date | 2007-08-01 |