| NPI | 1942345806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP1714) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA 21878) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-02-07 |