| NPI | 1184827115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 002404) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: PA DN007102) |
| 133V00000X Dietitian, Registered (Licence: NY 1085359) | |
| 174H00000X Health Educator | |
| 225700000X Massage Therapist (Licence: NY 12211) | |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-02-11 |