| NPI | 1184988107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00081300) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00648800) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2020-12-09 |