| NPI | 1548960867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC6428) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC28510) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-08-07 |