NPI | 1477675908 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 05172) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U272) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2008-03-06 |