| NPI | 1336586247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC165016) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 13040) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2014-08-12 |