| NPI | 1083752133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00074500) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U01369) |
| 171100000X Acupuncturist (Licence: VA 0121000393) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-07-22 |