| NPI | 1669564001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC29408) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 29408) |
| 171100000X Acupuncturist (Licence: CA 10593) | |
| 171100000X Acupuncturist (Licence: CA AC10593) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-07-08 |