| NPI | 1114063708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 16330) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 9187) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |