| NPI | 1184184244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A22622) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 318847-A) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101027170) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 318847) | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-09-22 |