| NPI | 1477572469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 273R00000X Psychiatric Unit (Licence: MI 4301038023) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171100000X Acupuncturist | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-05-10 |