| NPI | 1669671780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC9838) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC27801) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2020-08-11 |