| NPI | 1285976522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC18031) |
| Additional Taxonomies | 101Y00000X Counselor |
| 225700000X Massage Therapist | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2023-03-22 |