| NPI | 1174970040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI ACU-837) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI MAT-9779) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |