| NPI | 1326777566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 007100) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MY00025200) |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2025-09-25 |