| NPI | 1346628922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 003564) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 019476) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |