| NPI | 1760429393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 30069) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC5654) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2019-12-06 |