| NPI | 1366054025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX 1808) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 2459) |
| 225700000X Massage Therapist (Licence: TX 100480) | |
| Enumeration Date | 2020-08-23 |
| Last Update Date | 2024-01-20 |