| NPI | 1144522038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032243) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005706) |
| Enumeration Date | 2010-11-27 |
| Last Update Date | 2022-03-03 |