| NPI | 1366810525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00113600) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 007203) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2022-12-15 |