| NPI | 1225121882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC27994) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC10600) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-03-24 |