| NPI | 1063050060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006616) |
| Additional Taxonomies | 171100000X Acupuncturist |
| 225700000X Massage Therapist (Licence: NY 028425) | |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2023-05-23 |