| NPI | 1679795470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: HI 324) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: HI 799) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2013-12-02 |