| NPI | 1760534812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC1464) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT9808) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-09-24 |