| NPI | 1407092281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00065600) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 003856) |
| Enumeration Date | 2008-12-27 |
| Last Update Date | 2020-11-07 |