| NPI | 1821325697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 2155) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00070200) |
| Enumeration Date | 2009-11-15 |
| Last Update Date | 2009-11-15 |