| NPI | 1215306485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI 1057) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI 8484) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-17 |