| NPI | 1548317175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM DOM 775) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000703) |
| 225700000X Massage Therapist (Licence: NM 4307) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-09-11 |