NPI | 1790229714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: CA 16891) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2016-12-09 |
Last Update Date | 2018-08-29 |