| NPI | 1952624447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 13195) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 837) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |