| NPI | 1740456326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 029918) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005416) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2022-07-29 |