| NPI | 1922777978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 3250) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 16598) |
| 225700000X Massage Therapist (Licence: FL MA101241) | |
| 171100000X Acupuncturist (Licence: FL AP4396) | |
| Enumeration Date | 2021-09-12 |
| Last Update Date | 2022-10-06 |