| NPI | 1033550553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 32674) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 15603) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2019-05-21 |