| NPI | 1932690609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 006256) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00132500) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2019-02-24 |