| NPI | 1902995053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC30283) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC12433) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-05-31 |