| NPI | 1912937442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC8688) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC32983) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2015-02-16 |