| NPI | 1992947485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 13035) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2023-06-08 |