| NPI | 1154487346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AK 681) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY16065) |
| 103TC0700X Psychologist Clinical (Licence: HI PSY714) | |
| 171100000X Acupuncturist (Licence: CA AC11872) | |
| 171100000X Acupuncturist (Licence: HI ACU847) | |
| 171100000X Acupuncturist (Licence: AK 172) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2016-01-18 |