| NPI | 1942579271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P014845) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NC 187) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2020-07-29 |