| NPI | 1558890418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005930) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 027555) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-07-21 |