| NPI | 1679810238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00096700) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004907) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2024-10-01 |