| NPI | 1881969970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP4345) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004748) |
| 225700000X Massage Therapist (Licence: NY 030665) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2025-06-30 |