| NPI | 1366057655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: TX AC02254) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT131480) |
| Enumeration Date | 2020-09-13 |
| Last Update Date | 2026-03-12 |