| NPI | 1063612505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 0008091) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ MZ000100) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |