| NPI | 1154595635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00123000) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 18KT00876800) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-02-05 |