| NPI | 1437169349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 371) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX AD00126) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-02-10 |