| NPI | 1154594570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC29170) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC11500) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2022-12-20 |