| NPI | 1952408817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 29975) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 11131) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-02-08 |