| NPI | 1356689285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 18998) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 16249) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2021-08-19 |