| NPI | 1720484058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 32863) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 16336) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2020-09-04 |