| NPI | 1215137971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 017070) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 002591) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2013-10-28 |