NPI | 1134504301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: MD UI02152) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: MD M04891) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2018-10-09 |