| NPI | 1699921593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC207357) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02713) |
| 225700000X Massage Therapist (Licence: OR 10989) | |
| 225700000X Massage Therapist (Licence: OR 6010) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2021-12-17 |