| NPI | 1215465711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI 1087) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI 12759) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2021-09-02 |