| NPI | 1366969701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00126300) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005995) |
| Enumeration Date | 2017-08-26 |
| Last Update Date | 2022-05-15 |