| NPI | 1376757716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI ACU - 377) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI LMT 2074) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |