| NPI | 1629348800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 31955) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 14887) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2024-04-30 |