| NPI | 1235272592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00117100) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X010708) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2025-08-07 |