| NPI | 1083920938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002406) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 904) |
| Enumeration Date | 2010-08-28 |
| Last Update Date | 2019-12-05 |