| NPI | 1174061956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005909) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 015929) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-03-03 |