| NPI | 1285784884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT3116) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: ME AC281) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2013-03-21 |