| NPI | 1750234027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ LAC-012312) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-05506) |
| Enumeration Date | 2026-02-17 |
| Last Update Date | 2026-02-26 |