| NPI | 1952832255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005993) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI acu-1201) |
| 225700000X Massage Therapist (Licence: HI mat-15109) | |
| 225700000X Massage Therapist (Licence: NY 026978) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-07-21 |