| NPI | 1538399670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004558) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 019129) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2019-09-12 |