| NPI | 1831425545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 001928) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: NY 024328) |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2011-01-25 |