| NPI | 1134575921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25mz00107200) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005048) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2020-10-09 |