| NPI | 1467700344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 2023) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000873) |
| 171100000X Acupuncturist (Licence: CA AC17725) | |
| 171100000X Acupuncturist (Licence: OR AC180187) | |
| 171100000X Acupuncturist (Licence: CO acu0002336) | |
| 225700000X Massage Therapist (Licence: VA 0019016277) | |
| 225700000X Massage Therapist (Licence: CO MT0000582) | |
| 225700000X Massage Therapist (Licence: OR 17539) | |
| 225700000X Massage Therapist (Licence: NC 19192) | |
| Enumeration Date | 2012-08-26 |
| Last Update Date | 2021-01-27 |