| NPI | 1518119213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00083100) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00588900) |
| 111N00000X Chiropractor (Licence: NY X010212-1) | |
| 171100000X Acupuncturist (Licence: NY 003310-1) | |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2015-04-09 |