| NPI | 1275738379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 22753) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 4848) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2011-08-02 |