| NPI | 1447591615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 3250) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA 51374) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2014-08-11 |