| NPI | 1992428684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007307) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 032577) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2024-11-20 |