| NPI | 1275365926 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007198-01) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 033089-01) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |