| NPI | 1710258876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00087500) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004058) |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2020-04-22 |