| NPI | 1073859393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00094300) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004739) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2021-08-12 |