| NPI | 1184790339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25mz00051600) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 3373) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |