| NPI | 1487872479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 2125) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: NY 8054) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |