| NPI | 1275737520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI LMT5268) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI 579LAC) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2025-09-11 |