| NPI | 1588617658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00346) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 3897) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |