NPI | 1871719419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC27614) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC10053) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |