| NPI | 1053357723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 002045) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 015944) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2007-07-08 |