| NPI | 1053865238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00120300) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 8986110) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |