| NPI | 1366283822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: SC 417) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC 13596) |
| 171100000X Acupuncturist (Licence: NC 2222) | |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2026-09-17 |