| NPI | 1518139666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 30701) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 3724) |
| 171100000X Acupuncturist (Licence: CA AC 12039) | |
| 171100000X Acupuncturist (Licence: MA 286658) | |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2023-05-26 |