| NPI | 1548274756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC27215) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC6979) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-10-22 |