| NPI | 1780707539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01187) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-29761) |
| 171100000X Acupuncturist (Licence: CA AC-10809) | |
| 171100000X Acupuncturist (Licence: NV 1027) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2018-05-22 |