| NPI | 1740549385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC 14629) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 5199) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2013-07-09 |