| NPI | 1801969738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA Dc15230) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC8361) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2008-08-27 |