| NPI | 1023170800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 005929) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MO 24006935) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-02-05 |