| NPI | 1609932565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP3017) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL ma43967) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-10-06 |