| NPI | 1083840508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 4102) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 021637) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |