| NPI | 1083438089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 4576) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL 106005) |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |