| NPI | 1871660423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5498) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC25274) |
| 171100000X Acupuncturist (Licence: AZ 371) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2012-09-11 |