| NPI | 1013215102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 31910) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC18771) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2024-11-14 |