| NPI | 1073129797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC18939) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 83912) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2023-06-20 |