| NPI | 1053358291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 006529) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MO 006529) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2023-12-15 |