| NPI | 1588893523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00067900) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000961) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2020-04-22 |