| NPI | 1033295118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 15056) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC821) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2016-08-16 |