| NPI | 1588095160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00101000) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005034-1) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2016-02-25 |