| NPI | 1316239320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00081700) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004547) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2018-05-16 |