| NPI | 1104090612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL ap1345) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA19004) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-18 |