| NPI | 1235107905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD027494E) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000555L) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2011-06-02 |