| NPI | 1790823110 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC00834) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 9292) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-07-03 |