| NPI | 1013958412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC29344) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC10702) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2014-01-27 |