| NPI | 1417985920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26261) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 13160) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-06-08 |