| NPI | 1477177608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006121) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 027643) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |