| NPI | 1841351004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MA 236593) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MA 2448) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-05-19 |