| NPI | 1730492711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00082700) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004377) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2012-03-19 |