| NPI | 1073763587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TN acu0000000086) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TN 711) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2016-01-17 |