| NPI | 1629292990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25mz00025400) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00354600) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |