NPI | 1255543500 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: CA DC 14535) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: MA 657) |
111NS0005X Chiropractor, Sports Physician (Licence: CA DC 14535) | |
111NS0005X Chiropractor, Sports Physician (Licence: MA 657) | |
171100000X Acupuncturist (Licence: CA AC 4378) | |
Enumeration Date | 2007-05-07 |
Last Update Date | 2010-08-15 |