| NPI | 1306082672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 01531) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: HI MFT-300) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI CSAC) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 00500-LC) | |
| 171100000X Acupuncturist (Licence: HI ACU-372) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2018-10-29 |