| NPI | 1942571237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NC 1060) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CA ND778) |
| 225700000X Massage Therapist (Licence: NC 19359) | |
| 225700000X Massage Therapist (Licence: OR 18580) | |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2021-06-22 |