| NPI | 1629674080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA AC6918) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC6918) |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |