NPI | 1679912463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 15697) |
Additional Taxonomies | 174400000X Specialist (Licence: CA Massage CAMTC #27258) |
225700000X Massage Therapist (Licence: CA 27258) | |
Enumeration Date | 2013-06-14 |
Last Update Date | 2023-02-07 |