| NPI | 1528679875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 5815) |
| Additional Taxonomies | 171100000X Acupuncturist |
| 175F00000X Naturopath | |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2024-08-26 |