| NPI | 1770907925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00040900) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 0996) |
| Enumeration Date | 2014-02-08 |
| Last Update Date | 2025-02-20 |