| NPI | 1043824162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007360) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 031981-01) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2024-03-29 |