| NPI | 1538405022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: SC ACUP381) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00096800) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2022-05-04 |