| NPI | 1710167630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00049900) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 0029831) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2007-11-08 |