| NPI | 1841565777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198.001440) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227001253) |
| Enumeration Date | 2012-03-10 |
| Last Update Date | 2020-01-27 |