| NPI | 1528726122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP4474) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH12264) |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2023-09-15 |