| NPI | 1255436515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 29987) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC13886) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2019-10-18 |