| NPI | 1578741815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00059600) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2024-04-03 |