| NPI | 1699924944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP2231) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA9200) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |