| NPI | 1487690772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 015671) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 002464) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-06-10 |