| NPI | 1871871582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO ACU.0002637) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 812) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2023-01-11 |