| NPI | 1992782510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003325A) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IN 84000078A) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2007-07-08 |