| NPI | 1386067155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005243) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 026797) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2014-02-10 |