| NPI | 1548369549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA AC8389) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA Ac8389) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-04-06 |