| NPI | 1558329102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OH 6934) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 106) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2025-09-11 |