| NPI | 1811904758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00037100) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NJ 26NR12516600) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 569098) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |