| NPI | 1477202372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: MD U02261) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP3101) |
| 225700000X Massage Therapist (Licence: MD M05949) | |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2022-03-20 |