| NPI | 1306917562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AK 401) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AK 003) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2007-07-08 |