| NPI | 1558680249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004587) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 023055) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2013-04-22 |