| NPI | 1073877114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ 010081) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00076900) |
| 171100000X Acupuncturist (Licence: NY 003806) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2022-09-29 |