| NPI | 1457590309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 2453) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 5934) |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2024-03-08 |