| NPI | 1497804553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00053200) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 44SW05189900) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 44SW05189900) | |
| 104100000X Social Worker (Licence: NJ 44SW05189900) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2019-12-13 |