| NPI | 1790848430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: HI ACU-737) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI MAT-8832) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2023-10-11 |