| NPI | 1528140290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 875) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 875-1) |
| 171100000X Acupuncturist (Licence: NJ 25mz00059400) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2022-02-14 |