| NPI | 1770919631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 004747-1) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00094500) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2014-11-03 |