| NPI | 1699882118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 22732) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC28150) |
| 171100000X Acupuncturist (Licence: CA AC9112) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-09-18 |