| NPI | 1417089905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 874) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NC 443) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2010-03-22 |