| NPI | 1235239138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 1355) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 760) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |