| NPI | 1033516737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 5412) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X014050) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2026-04-15 |