| NPI | 1578911210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00119700) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005720) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |