| NPI | 1174279202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25M200152400) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 007233-01) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-12-28 |