| NPI | 1447517263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006206) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 26bt00387300) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2021-01-03 |