| NPI | 1538635172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U02426) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MD M04077) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2021-08-02 |