| NPI | 1538447230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26736) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC10180) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2015-01-25 |