| NPI | 1689142226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 19100) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 64329) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2021-04-26 |