| NPI | 1689099798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00108800) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005250) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2020-09-21 |