| NPI | 1225680879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 35141) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 18256) |
| Enumeration Date | 2019-07-14 |
| Last Update Date | 2026-05-23 |