| NPI | 1205122231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25mz00080200) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 003970-1) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |