| NPI | 1487847893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AK 0069) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AK MT 1181) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |