| NPI | 1144058629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 032657) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 007634) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-11-18 |