| NPI | 1538292008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP 2677) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA 41564) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-07-23 |