| NPI | 1750445821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC-29620) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC-13010) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2016-06-17 |