| NPI | 1932373842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC01160) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR LMT15144) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2014-03-20 |