| NPI | 1689204562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC18315) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP4120) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2021-10-15 |