| NPI | 1043610348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 33051) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 16223) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2021-01-24 |