| NPI | 1205231974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA ac16291) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 57500) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |