| NPI | 1407359276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 3926) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL 3390372) |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2018-03-17 |