| NPI | 1689897480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 6424) |
| Additional Taxonomies | 171100000X Acupuncturist |
| 171100000X Acupuncturist (Licence: CO 663) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-04-23 |