| NPI | 1578631974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC3890) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC19535) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2009-07-15 |