| NPI | 1306031133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: CA 30150) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CA 30150) |
| 111NS0005X Chiropractor, Sports Physician (Licence: CA 30150) | |
| 171100000X Acupuncturist (Licence: CA 11958) | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2018-09-25 |