| NPI | 1164744074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 003887) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00072800) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |