| NPI | 1144862822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007088) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 030560) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2022-02-17 |