| NPI | 1528303203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 31867) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 14127) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |