| NPI | 1972168318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001255) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MSG003056) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |