NPI | 1053513432 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: CA PSY4685) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC126) |
Enumeration Date | 2007-06-05 |
Last Update Date | 2013-07-23 |