| NPI | 1619257219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00099900) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 003469-1) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2023-06-14 |