| NPI | 1023614732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007457) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 030988) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2024-04-28 |