| NPI | 1053629832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP2881) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: FL MA40831) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |