| NPI | 1598193963 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC15591) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP3168) | 
| Enumeration Date | 2013-10-23 | 
| Last Update Date | 2024-09-04 |