| NPI | 1891097895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MN 1511) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MN 171040) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2018-03-17 |