| NPI | 1275084253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: LA 320569) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198001421) |
| 173C00000X Reflexologist (Licence: IL 227015336) | |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2019-09-02 |