| NPI | 1801121678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC-31411) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC16721) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2015-11-20 |