| NPI | 1629783618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 19537) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 51197) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-01-13 |