| NPI | 1306280920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00104000) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 15221) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-07-21 |