| NPI | 1952519571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC 4833) | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC 20636) | 
| Enumeration Date | 2007-05-18 | 
| Last Update Date | 2025-09-11 |