| NPI | 1285758037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP1475) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA16588) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-11-27 |