| NPI | 1821415183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC 15822) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: CA A000150) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2023-03-24 |