| NPI | 1023344165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 001184) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00036900) |
| 171100000X Acupuncturist (Licence: CT 000295) | |
| Enumeration Date | 2009-10-25 |
| Last Update Date | 2009-10-25 |