| NPI | 1124387287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00030400) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001627) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2023-03-28 |