| NPI | 1669687661 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00073300)  | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001200)  | 
| Enumeration Date | 2007-05-11 | 
| Last Update Date | 2016-03-16 |