| NPI | 1730401225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 1221) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NM 5954) |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2018-03-22 |