| NPI | 1235188905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH2630) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP 1008) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2023-05-09 |