| NPI | 1407201015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 4669) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 15620) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2026-02-18 |