| NPI | 1356004071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 6868) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00156100) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-11-08 |