| NPI | 1588821474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 3667) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 018268) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2025-06-28 |