| NPI | 1447238134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 223483) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A223483-1) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-01-31 |