| NPI | 1073528873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 001478) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 023824) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2025-09-11 |