| NPI | 1235332016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00015000) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001181-1) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2011-08-19 |