| NPI | 1982218152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007103) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 029967) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2022-06-01 |