| NPI | 1508909748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 014071) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001272-1) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2011-10-19 |