| NPI | 1760618532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist |
| Additional Taxonomies | 225700000X Massage Therapist |
| 367H00000X Anesthesiologist Assistant | |
| 211D00000X Assistant, Podiatric | |
| 133N00000X Nutritionist | |
| 2251H1200X Physical Therapist, Hand | |
| Enumeration Date | 2009-06-06 |
| Last Update Date | 2010-04-16 |