| NPI | 1467820571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 16982) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 56189) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2018-05-22 |