| NPI | 1407192479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP-3997) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00103800) |
| 171100000X Acupuncturist (Licence: NY 004685) | |
| 225700000X Massage Therapist (Licence: NY 021639) | |
| 225700000X Massage Therapist (Licence: FL MA-90771) | |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2021-08-25 |