| NPI | 1720243405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00063200) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 26BT00338400) |
| 225700000X Massage Therapist (Licence: NY 023451) | |
| 171100000X Acupuncturist (Licence: NY 003828) | |
| 171100000X Acupuncturist (Licence: CA AC14000) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2019-07-02 |