| NPI | 1619480035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC35200) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60812081) |
| 172V00000X Community Health Worker | |
| 175F00000X Naturopath (Licence: CA ND1058) | |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2025-03-12 |