| NPI | 1629498837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004929) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 014016) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2014-04-27 |