| NPI | 1528070331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7927) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 0632) |
| 171100000X Acupuncturist (Licence: IA A31) | |
| 171100000X Acupuncturist (Licence: NH 004) | |
| 171100000X Acupuncturist (Licence: MA 365) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2008-09-05 |