| NPI | 1710294673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL 1445) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 3062) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2010-09-13 |