| NPI | 1124664719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00150500) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 006575) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2021-04-29 |