| NPI | 1811555634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006770-01) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 018439) |
| 225700000X Massage Therapist (Licence: NY 018439-01) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2021-09-13 |