| NPI | 1467639443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC161230) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA LAcAC11154) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |