| NPI | 1306552195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 005964) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25NZ00137300) |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2025-05-12 |