| NPI | 1427490465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC32678) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA ac19143) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2021-06-29 |