| NPI | 1770815805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC11943) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC30952) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |