| NPI | 1588285241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006474-1) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 030074-1) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2023-09-13 |