| NPI | 1083830863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH2616) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP488) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2014-05-29 |