| NPI | 1497047443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00151400) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NJ 40QB00254400) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2021-03-09 |