| NPI | 1932413903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004414) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 019854) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2016-12-09 |