| NPI | 1700172285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC12984) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 12984) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2015-10-14 |