| NPI | 1386918928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 28831) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 9420) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2019-03-07 |