| NPI | 1194484170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007177) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 031878) |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2022-09-15 |