| NPI | 1730257999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: HI DOS1751) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI ACU580) |
| 225700000X Massage Therapist (Licence: HI MAT5108) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2021-09-09 |