| NPI | 1265736508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00104200) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 2025-000205) |
| 171100000X Acupuncturist (Licence: DE CQ-0000029) | |
| 101YP2500X Counselor, Professional (Licence: NJ 37AC00916700) | |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2025-10-31 |